European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery最新文献

{"title":"The cost-effectiveness of unilateral cochlear implantation in the Finnish health care.","authors":"Aarno Dietz, Elizabeth Seil, Pia Linder, Ismo Linnosmaa, Bonny Parkinson, Henry Cutler","doi":"10.1007/s00405-025-09468-9","DOIUrl":"https://doi.org/10.1007/s00405-025-09468-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study estimates the cost-effectiveness of unilateral cochlear implants (UCIs) for Finnish adults with severe to profound hearing loss within the contemporary Finnish healthcare system.</p><p><strong>Methods: </strong>We conducted a cost-utility analysis using a Markov model to compare UCIs with hearing aids for adults with severe to profound hearing loss. We developed an average clinical pathway based on data from three Finnish university hospitals to estimate resource use. The model captured health-related quality of life, potential adverse events, device upgrades, and device failure. We estimated unit costs from national expert opinions and from grey and published literature. We performed a probabilistic sensitivity analysis to evaluate how uncertain model inputs affect the incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>The ICER for UCIs compared to hearing aids in the Finnish adult population was €14,528 per quality-adjusted life year (QALY). The cost-effectiveness acceptability curve indicated a 98,5% likelihood that UCIs are cost-effective compared to a €25,000 per QALY gained threshold. The ICER was most sensitive to the discount rate, UCI device and surgery costs, the utility increment from UCI treatment, costs associated with UCI fitting, and the cost and upgrade cycle of sound processors.</p><p><strong>Conclusion: </strong>UCIs for adults are cost-effective within the Finnish healthcare setting. Our results align with ICER findings for UCIs in the UK and Swedish adult populations, despite differences in indications, clinical pathways, and device unit costs. All studies suggest that UCIs are more cost-effective when implemented at an earlier age, given the same level of hearing performance.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of osteopathic manipulation techniques for management of acute otitis media in pediatric patients: a scoping review.","authors":"Cory Hyun-Su Kim, Lauren R McCray, Shaun A Nguyen, Carl Shermetaro, Wayne K Robbins","doi":"10.1007/s00405-025-09492-9","DOIUrl":"https://doi.org/10.1007/s00405-025-09492-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To map and summarize the existing literature on the use of osteopathic manipulative techniques (OMT) in the management of acute otitis media (AOM) in pediatric patients, with an emphasis on reported outcomes and identifying gaps in the current evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;CINAHL, PubMed, and SCOPUS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Review methods: &lt;/strong&gt;A comprehensive literature search was conducted across multiple databases following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Studies were charted and summarized based on key characteristics, including study design, population, types of OMT applied, and reported outcomes on management of AOM and recurrent AOM in pediatric patients using OMT. No formal meta-analysis was performed, and all outcome measures were descriptively synthesized.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three randomized controlled trial (RCT) studies and one pilot cohort study (N = 205) pertaining to application of OMT in pediatric patients with otitis media were included. Mean age for OMT and control (either sham OMT or standard of care) groups were 19.1 months and 16.8 months; proportions of males were 53.2% and 55.9%, respectively. In the pilot cohort study done by Degenhardt and Kuchera, 62.5% of the subjects experienced no documented recurrence of AOM symptoms at one year post-OMT intervention follow-up; however, since no control group was available for this study, any statistical comparison of recurrence-free rate was unfeasible. In the RCT study by Mills et al., the OMT group showed statistically significant effects on reducing frequency of mean monthly AOM episodes, resulting in fewer surgical procedures, delaying surgical interventions, increasing resolution of middle ear effusion and better tympanogram readings based on mean sum of types A and C tympanograms, and higher parental satisfaction with overall experience and perceived effectiveness of the OMT on their children on a scale of 0 to 5 when compared to the control group. While statistical interpretation showed some significance in various aspects, OMT's clinical significance remained questionable, especially considering natural course of healing in AOM. In the other RCT study by Steele et al., at the second-week visit during the 3-week OMT intervention period, the OMT group showed a significantly higher likelihood of middle ear effusion resolution based on tympanogram findings and acoustic reflectometer measurements, respectively. However, at one month follow-up visit, there was no statistical significance, alluding to the limited effects of OMT. Finally, in the last RCT study by Whal et al., the OMT group failed to show any significant effects on prevention of recurrence of AOM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Current literature on the use of OMT for acute and recurrent otitis media in pediatric patients suggests, with low certainty, that OMT may pr","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety profiles of bone-conduction hearing implants revisited: A meta-analytic comparison adjusted for follow-up time.","authors":"Marco Caversaccio, Wilhelm Wimmer, Annegret Hoch, Thomas Dejaco, Burkard Schwab","doi":"10.1007/s00405-025-09502-w","DOIUrl":"https://doi.org/10.1007/s00405-025-09502-w","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate incidence rates of adverse events associated with bone-conduction hearing implants from primary literature and to compare rates among different technological designs.</p><p><strong>Methods: </strong>A systematic literature review and meta-regression was conducted to estimate incidence rates of minor and major complications and their consequences (i.e., revision surgery, explantation, re-implantation and becoming a non-user) while testing for effects of device design, age group, mean follow-up time and study type. These four designs of bone-conduction systems were included: 1) active transcutaneous with electromagnetic transducer (aBCIem), 2) active transcutaneous with piezoelectric transducer (aBCIpz), 3) passive transcutaneous (tBAHA), and 4) passive percutaneous (pBAHA).</p><p><strong>Results: </strong>The final dataset included 170 articles reporting on 6451 implantations and 1847 minor and 668 major events. Mean follow-up time was a significant predictor of incidence rates (p < 0.001), with lower rates reported in studies with longer follow-up times. After adjusting to the median follow-up time, the pooled incidence rate of minor complications was significantly lower in aBCIem (p < 0.05) compared to other designs. For both major events and revision surgery, pooled incidence rates were significantly higher in pBAHA compared to aBCIem (p < 0.001) and tBAHA (p < 0.001), but not compared to aBCIpz (Major: p = 0.197; Revision: p = 0.248). Becoming a non-user occurred significantly more frequently in tBAHA compared to other designs (p < 0.005). No statistically significant differences were found in rates of explantation and explantation with re-implantation.</p><p><strong>Conclusion: </strong>When comparing across multiple studies, adverse event rates should be adjusted for different lengths of follow-up. Synthesizing published evidence without considering follow-up time may lead to false conclusions.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical decision support using large language models in otolaryngology: a systematic review.","authors":"Rania Filali Ansary, Jerome R Lechien","doi":"10.1007/s00405-025-09504-8","DOIUrl":"https://doi.org/10.1007/s00405-025-09504-8","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review evaluated the diagnostic accuracy of large language models (LLMs) in otolaryngology-head and neck surgery clinical decision-making.</p><p><strong>Data sources: </strong>PubMed/MEDLINE, Cochrane Library, and Embase databases were searched for studies investigating clinical decision support accuracy of LLMs in otolaryngology.</p><p><strong>Review methods: </strong>Three investigators searched the literature for peer-reviewed studies investigating the application of LLMs as clinical decision support for real clinical cases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following outcomes were considered: diagnostic accuracy, additional examination and treatment recommendations. Study quality was assessed using the modified Methodological Index for Non-Randomized Studies (MINORS).</p><p><strong>Results: </strong>Of the 285 eligible publications, 17 met the inclusion criteria, accounting for 734 patients across various otolaryngology subspecialties. ChatGPT-4 was the most evaluated LLM (n = 14/17), followed by Claude-3/3.5 (n = 2/17), and Gemini (n = 2/17). Primary diagnostic accuracy ranged from 45.7 to 80.2% across different LLMs, with Claude often outperforming ChatGPT. LLMs demonstrated lower accuracy in recommending appropriate additional examinations (10-29%) and treatments (16.7-60%), with substantial subspecialty variability. Treatment recommendation accuracy was highest in head and neck oncology (55-60%) and lowest in rhinology (16.7%). There was substantial heterogeneity across studies for the inclusion criteria, information entered in the application programming interface, and the methods of accuracy assessment.</p><p><strong>Conclusions: </strong>LLMs demonstrate promising moderate diagnostic accuracy in otolaryngology clinical decision support, with higher performance in providing diagnoses than in suggesting appropriate additional examinations and treatments. Emerging findings support that Claude often outperforms ChatGPT. Methodological standardization is needed for future research.</p><p><strong>Level of evidence: </strong>NA.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effectiveness of bone obliteration in cholesteatoma surgery.","authors":"J Chomarat, C Fabre, S Schmerber, Raphaële Quatre","doi":"10.1007/s00405-025-09508-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09508-4","url":null,"abstract":"<p><strong>Objective: </strong>The main objective of this study was to compare the residual and recurrence rates in canal wall up, canal wall down, and canal wall down with reconstruction tympanoplasty for the treatment of cholesteatoma, considering the different filling materials used: no mastoid obliteration versus obliteration using Bone Pate versus obliteration using G45S5 (Glassbone^®).</p><p><strong>Methods: </strong>This was a retrospective cohort study conducted at a single tertiary medical center. Patient who underwent canal wall up, canal wall down or canal wall down with reconstruction tympanoplasty for a cholesteatoma (primary, secondary, recurrent or residual), with or without mastoid obliteration, with Bone Pate or G45S5 between January 2007 and March 2023 were included. Patients with congenital cholesteatoma and with a follow-up less than 6 months or with any other type of surgery techniques were excluded.</p><p><strong>Results: </strong>A hundred and eight (46%) surgeries were performed without any mastoid obliteration, 66 (28%) with Bone Pate obliteration and 62 (26%) with G45S5 obliteration with a total of 236 surgeries. Survival analysis revealed significantly better outcomes for the Bone Pate cohort compared to without obliteration cohort on the recurrence and recidivism rate (HR 0.26; p = 0.03 and HR 0.39; p = 0.01 respectively). However, none of the statistical analyses showed significant differences between the non-obliteration cohort and the G45S5 cohort.</p><p><strong>Conclusion: </strong>Our study highlights the benefits of Bone Pate obliteration in cholesteatoma surgery. However, it does not provide conclusive evidence on the effectiveness of G45S5 obliteration in preventing residual and recurrent cholesteatoma.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dutch translation and validation of the Visual Vertigo Analogue Scale (VVAS).","authors":"Marie Reynders, Wilfried Cools, Kelsey Van Den Houte, Elke Lichtert, Ina Foulon","doi":"10.1007/s00405-025-09455-0","DOIUrl":"https://doi.org/10.1007/s00405-025-09455-0","url":null,"abstract":"<p><strong>Background: </strong>Visual vertigo (VV) is dizziness triggered by visually complex environments and is common in vestibular disorders such as Persistent Postural Perceptual Dizziness (PPPD). The Visual Vertigo Analogue Scale (VVAS) is a validated tool for assessing VV severity, but no Dutch version is currently available.</p><p><strong>Objective: </strong>This study involved translating the original English version of the VVAS into Dutch, followed by adaptation and validation to ensure reliability and consistency with the source version.</p><p><strong>Methods: </strong>The VVAS was translated using forward-backward translation. The final version was tested in 104 participants (PPPD patients and healthy controls). Internal consistency (Cronbach's alpha), test-retest reliability (Intraclass Correlation Coefficient), and construct validity (factor analysis and regression modeling) were assessed.</p><p><strong>Results: </strong>The Dutch VVAS showed high internal consistency (Cronbach's alpha = 0.93), comparable to the original version. Test-retest reliability was adequate (ICC = 0.67). VVAS scores were significantly higher in PPPD patients compared to healthy controls (p < 0.001), controlling for age and gender.</p><p><strong>Conclusion: </strong>The Dutch VVAS is a reliable and valid tool for assessing VV in Dutch-speaking populations, making it suitable for clinical and research applications.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of EAONO/JOS and ChOLE Classifications in Cholesteatoma in Terms of Intraoperative Findings and Postoperative Results.","authors":"Esra Aydin Sudabatmaz, Mehmet Akif Abakay, Filiz Gulustan, Zahide Mine Yazici","doi":"10.1007/s00405-025-09423-8","DOIUrl":"https://doi.org/10.1007/s00405-025-09423-8","url":null,"abstract":"<p><strong>Purpose: </strong>In recent years, various classifications have been proposed for cholesteatoma staging, including the European Academy of Otology and Neurotology and the Japanese Society of Otology (EAONO/JOS) system and the ChOLE system. The objective of our study is to compare these two staging systems in terms of surgical technique, intraoperative findings, postoperative results, and recidivism.</p><p><strong>Methods: </strong>Patients aged 18 and above who underwent surgery at our hospital for chronic otitis media with histopathologically confirmed cholesteatoma between January 2016 and January 2021 were included in the study. The cholesteatoma stage was retrospectively determined using the EAONO/JOS and ChOLE systems. Surgical techniques, intraoperative findings, presence of recidivism within one year, pre- and postoperative air and bone conduction thresholds (ACT and BCT) and air-bone gap (ABG) were examined.</p><p><strong>Results: </strong>As the ChOLE stage increases, the frequency of each of the intraoperative findings (facial canal dehiscence, LSSK fistula, tegmen defect, external auditory canal erosion) increases. As the EAONO/JOS stage increases, only the incidence of facial canal dehiscence and external auditory canal erosion increases. As the EAONO/JOS stage increases, ACT and BCT and ABG increase. As the ChOLE stage increases, ACT and BCT values increase. Additionally, as the stage increased in both systems, CWD techniques were performed more frequently in surgery.</p><p><strong>Conclusion: </strong>According to our study, ChOLE is more correlated with intraoperative findings and EAONO/JOS is more correlated with audiological results. Although there is no correlation between these stagings and recidivism, both staging systems are related to surgical technique.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BDNF as a biomarker for evaluating clinical response in allergic rhinitis patients undergoing allergen-specific immunotherapy.","authors":"Hongping Zhang, Yiran Zang, Xu Li, Hongyang Zhang, Xiaoxue Zi, Peng Jin, Lili Zhi","doi":"10.1007/s00405-025-09498-3","DOIUrl":"https://doi.org/10.1007/s00405-025-09498-3","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to compare the correlation between serum brain-derived neurotrophic factor (BDNF) level and clinical, immunological parameters in patients receiving allergen-specific subcutaneous immunotherapy (SCIT) for 3 years duration.</p><p><strong>Methods: </strong>Comparing serum BDNF levels in AR patients and healthy controls, the correlation between serum BDNF level and clinical parameters in AR patients was analyzed further. Immunological parameters, including total IgE, d1 sIgE and d2 sIgE, serum BDNF levels, and the clinical parameters were evaluated at the 4-time points that including before immunotherapy, the end of the 1st, 2nd, and 3rd year during the SCIT treatment for AR patients who received immunotherapy.</p><p><strong>Results: </strong>We found a significantly elevated expression level of serum BDNF levels in AR patients and it also showed a significant correlation with nasal symptom score that included itching score, nasal obstruction score, runny nose, total nasal symptom score, and peripheral parameters including eosinophil percent and eosinophil count. For AR patients who received immunotherapy, a good response was shown, the expression of serum BDNF levels showed a downward trend during 3 years of SCIT, and it significantly positively correlated with the improvement of nasal symptoms including nasal obstruction, nasal itching, and medicine score.</p><p><strong>Conclusion: </strong>Serum BDNF level was associated with clinical severity in AR patients and clinical parameters in AR patients in SCIT duration, which should be considered as a response evaluation biomarker to monitor clinical efficacy in allergen-specific immunotherapy.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors of metastasis in lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma.","authors":"Huan-Rong Cao, Wen-Jin Lin, You-Jia Lin, Yu Chen, Rong-Xi Liang","doi":"10.1007/s00405-025-09503-9","DOIUrl":"https://doi.org/10.1007/s00405-025-09503-9","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to determine the risk factors associated with lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in patients with papillary thyroid carcinoma (PTC).</p><p><strong>Method: </strong>A total of 1381 patients diagnosed with PTC who underwent right or total thyroidectomy were included in this retrospective study. The relationship between clinicopathological variables and metastasis to lymph nodes posterior to the right recurrent laryngeal nerve was evaluated using both univariate and multivariate analyses.</p><p><strong>Results: </strong>Right-sided Central Lymph Node (CLN) positivity was detected in 42.8% (591/1381) of patients.The metastasis rates for LN-arRLN and LN-prRLN were 36.5% (504/1381) and 17.89% (247/1381), respectively. Simultaneous metastasis to both LN-arRLN and LN-prRLN was present in 11.59% (160/1381) of patients. Furthermore, among patients without LN-arRLN metastasis, the metastasis rate for LN-prRLN was 9.8% (87/887). Factors associated with an increased risk of LN-arRLN metastasis include gender, age, maximum tumor diameter, microcalcification, thyroid capsule invasion, prelaryngeal lymph node metastasis, pretracheal lymph node metastasis, and lateral neck lymph node metastasis. Furthermore, maximum tumor diameter, proximity to the posterior medial capsule, prelaryngeal lymph node metastasis, LN-arRLN metastasis, left central lymph node metastasis, and lateral neck lymph node metastasis were identified as independent predictors of LN-prRLN metastasis(P<0.001).</p><p><strong>Conclusion: </strong>In conclusion, LN-prRLN metastasis is relatively common in patients with PTC. For those undergoing central lymph node dissection (CLND), LN-prRLN dissection should be considered when high-risk features are present, including maximum tumor diameter > 1 cm, proximity to the posterior medial capsule, prelaryngeal lymph node metastasis, LN-arRLN metastasis, left central lymph node metastasis, and lateral neck lymph node metastasis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining swallowing parameters of the Yale Swallow Protocol in healthy individuals: Establishing Normative Data.","authors":"Angela Van Sickle, Ed M Bice, Abdul Awal, Debra Suiter","doi":"10.1007/s00405-025-09483-w","DOIUrl":"https://doi.org/10.1007/s00405-025-09483-w","url":null,"abstract":"<p><strong>Purpose: </strong>Currently, the Yale Swallow Protocol overidentifies prandial aspiration. The current investigation aimed to establish normative data for the number of swallows, average volume per swallow, time to complete, and integrated surface electromyography signal (area under the curve) for the consumption of 3 oz (90 mL) of water.</p><p><strong>Methods: </strong>Participants were divided into three groups: younger adults (n = 65, = 22.8 years), middle-aged adults (n = 62, = 53.2 years), and older adults (n = 65, = 81.5 years). Participants consumed 3 oz (90 mL) of water while connected to a surface electromyography device. Descriptive statistics and the main effects of age were computed.</p><p><strong>Results: </strong>Data for the number of swallows, average volume per swallow, time to complete, and integrated surface electromyography signal (area under the curve) were reported. For the 3-oz (90 mL) task, the number of swallows consistently increased as age increased. Younger and middle-aged adults consumed 3 oz of water with a statistically significant fewer number of swallows when compared to older adults (younger p = 0.008 and middle-aged p = 0.017). Although it did not reach statistical significance, younger adults swallowed fewer times than middle-aged adults (p = 0.822). The average volume per swallow decreased as age increased. Although younger and middle-aged adults consumed similar average volumes per swallow, younger adults swallowed a statistically significant greater average amount per swallow than older adults (p = 0.001) as did middle-aged adults (p = 0.001). The time to complete increased as age increased. Although there were no statistically significant differences between younger and middle-aged adults, older adults took significantly more time to consume 3 oz of water than middle-aged adults (p = 0.004) and younger adults (p = 0.001). The middle-aged adults had the smallest, and younger adults had the largest area under the curve. There were significant differences between younger and middle-aged adults (p = 0.004) and middle-aged and older adults (p = 0.043).</p><p><strong>Conclusion: </strong>The study provided normative data for number of swallows, average volume per swallow, time to complete, and integrated surface electromyography signal or area under the curve while consuming 3 oz (90 mL) of water. Data from the current study provides a foundation for future research to examine the sensitivity and specificity of the YSP using additional parameters.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}